{% extends 'base.html' %}

{% block title %}
    注册
{% endblock %}

{% block head %}
    <link rel="stylesheet" href="{{ url_for('static', filename='css/login_regist.css') }}">
    <link rel="stylesheet" href="{{ url_for('static', filename='css/complete_infos.css') }}">
{% endblock %}

{% block main %}
    <h3 class="page-title">注册</h3>
    <form action="" method="POST">
        <div class="form-container">
            <h4>--基本信息--</h4>

            <div class="form-group">
                <input type="text" class="form-control" placeholder="手机号码" name="telephone">
            </div>
            <div class="form-group">
                <input type="text" class="form-control" placeholder="用户名" name="username">
            </div>
            <div class="form-group">
                <input type="password" class="form-control" placeholder="密码" name="password1">
            </div>
            <div class="form-group">
                <input type="password" class="form-control" placeholder="确认密码" name="password2">
            </div>

            <h4>--个人健康信息--</h4>

            <div class="form-group">
                <input type="text" class="form-control" placeholder="身份证号" name="id_card">
            </div>
            <div class="form-group">
                <input type="text" class="form-control" placeholder="姓名" name="username">
            </div>
            <div class="form-group">
                <input type="text" class="form-control" placeholder="性别" name="sex">
            </div>
            <div class="form-group">
                <input type="date" class="form-control" placeholder="出生日期" name="birthday">
            </div>
            <div class="form-group">
                <input type="email" class="form-control" placeholder="电子邮箱" name="email">
            </div>
            <div class="form-group">
                <input type="text" class="form-control" placeholder="亲属手机号" name="family_telephone1">
            </div>
            <div class="form-group">
                <input type="text" class="form-control" placeholder="关系" name="relationship1">
            </div>
            <div class="form-group">
                <input type="text" class="form-control" placeholder="亲属手机号" name="family_telephone2">
            </div>
            <div class="form-group">
                <input type="text" class="form-control" placeholder="关系" name="relationship2">
            </div>

            <div class="form-group">
                <button class="btn btn-primary btn-block">立即注册</button>
            </div>
        </div>
    </form>
{% endblock %}